The turricephaly index: A validated method for recording turricephaly and its natural history in Apert syndrome

Abstract

Introduction: We present the CT scan-derived turricephaly index (TI) as a quotient of the maximal occipito-frontal length of the skull to the distance from the centre of the sella to the highest point on the vertex as a validated tool for assessing turricephaly and evaluating surgical techniques.Materials and Methods: TI measurements were taken from CTs from non-operated children with Apert syndrome and age-matched controls and analysed using Centricity PACS system (from the lateral scout image) and Osirix (the thick-sliced Osirix tool).CTs from non-operated children with Apert syndrome were used to investigate the natural history of turricephaly.Results: There was statistically significant agreement between measurements taken from the CT scout and Osirix for 42 control children (R 2 =0.97) and 42 children with Apert syndrome (R 2 = 0.98) and between two separate observers. There was a statistically significant difference (p<0.001) between CT scout-derived TI value between controls (1.730.12, range 1.46 -1.99) and Apert children (1.420.15, range 1.13 -1.73).Analysis of 113 CTs of 65 non-operated children with Apert syndrome showed a decrease in turricephaly with age (positive spearman correlation: r = 0.50, p<0.001).Analysis of 37 CTs of those with multiple (>2) CT's showed a decrease in turricephaly in the individual child (p<0.001).

The Esthetic Perception of Morphological Severity in Scaphocephalic Patients is Correlated With Specific Head Geometrical Features

“…From the lateral projection (Figure 2D), the following geometrical parameters were quantified: - Anterior prominence: Horizontal distance between the nasion and the most prominent point of the forehead. - Posterior prominence: Horizontal distance between the model’s most posterior base point and the most prominent point of the occiput. - Take-off angle: Angle defined by the most prominent point of the forehead, the nasion, and the horizontal plane - Average frontal vertical curvature: The average curvature of the anterior half silhouette. - Average posterior vertical curvature: The average curvature of the posterior half silhouette. From the horizontal projection (Figure 2E), the following geometrical parameters were quantified: - Average frontal horizontal curvature: The average Gaussian curvature of the anterior half projection. - Average posterior horizontal curvature: The average Gaussian curvature of the posterior half projection. For each model, height, length, and width were measured (Figure 1B and 1C). CI was calculated as width over length; turricephaly index (TI) 16 was calculated as height over length.…”

“…For each model, height, length, and width were measured (Figure 1B and 1C). CI was calculated as width over length; turricephaly index (TI) 16 was calculated as height over length.…”

Early posterior vault distraction osteogenesis changes the syndromic craniosynostosis treatment paradigm: long-term outcomes of a 23-year cohort study

“…Preoperative fine-cut (1 mm or less) head CT scans were analyzed on Mimics Version 23.0 (Materialise, Leuven, Belgium) to evaluate baseline morphometrics. Five linear distances [27], frontal bossing angle [11,28], and turricephaly index [29,30] were measured. Distances included cranial width, cranial length, and three cranial heights (anterior, middle, and posterior) (Supplemental Fig.…”

Anemias in ancient Egyptian child mummies: Computed tomography investigations in European museums

“…Lamellation of the diploic space was discernible in the occipital bone. The skull was elongated in the form of a tower skull and revealed a pathological turricephaly index of 146 (O'Hara et al, 2019). There was also a distinct osseous expansion of the facial bones as well as dental malocclusion with maxillary overbite resulting in features of "rodent facies" (Figures 2 and 3).…”